The gift of life proving to be the greatest threat to newborns

While under five mortality rates are on the decline, newborns are still bearing the brunt of healthcare systems struggling to provide basic healthcare to safeguard the birth process and critical weeks that follow. The first ever Global Conference on Newborn Health took place in South Africa this month. A fitting venue perhaps, as Africa’s greatest economy still faces many challenges as it strives to reduce infant mortality. It is estimated that more than 20,000 died in South Africa in 2011.

Cacadu, South Africa, 18 April 2013 - Eighteen-year-old Nandipa’s heart raced as the contractions occurred closer and closer together. She had been looking forward to welcoming her son into the world and had already named him “Silindokuhle”, a traditional Xhosa name meaning “we are waiting for a good thing to come to us”. But Silindokuhle’s arrival was ahead of the date the young mother was expecting him. Two months prematurely the little boy bravely fought his way into the world, and survived.

Statistically, the most life threatening event that a child will face in its life, is birth itself. Being fortunate enough to survive the process of coming into the world, the 28 days that follow are absolutely critical to a young child’s survival.

These, among other chilling statistics were presented to attendees at the first ever Global Newborn Health Conference that was held in South Africa from 15-18 April.

Many other threats can lay claim to the vulnerable fragile newborn. Breathing complications and severe infections lead to nearly 80% of the three million annual deaths within the first month of a baby’s life. Both conditions are largely preventable and also treatable, yet by the time you finish reading this article, ten babies would have lost the fight to stay alive.

“When a family hears of a pregnancy and of a birth, the response is to celebrate this new life and the opportunity and joy to watch a child grow up healthy,” said humanitarian and wife of Nelson Mandela Ms. Graça Machel speaking at the opening of the Global Newborn Health Conference “Yet each year, for millions of parents, this joy ends in tragedy as children needlessly die in the first month of life from preventable causes.”

A call to action

A growing percentage of child deaths occur during the first month. In 1990 newborn deaths accounted for 36 per cent of these deaths – last year 3 million of the 6.9 children that died before the age of five, were newborns. This is the one area where countries are failing as far as reducing under five mortality rates is concerned.

The Conference focused on addressing the challenges and opportunities involving the roll out of life-saving innovative interventions including low-cost medicines, equipment and health strategies such as exclusive breastfeeding from within the first hour of birth up to at least six months of age.

Ultimately, the focus was on helping countries develop action plans designed to reduce the deaths of babies during the first month of life.

“With less than 1000 days to reach the Millennium Development Goal 4 of reducing under-5 child mortality rates, saving newborn lives is instrumental to our success,” said Geeta Rao Gupta, UNICEF Deputy Executive Director. “We need to act on the evidence available that clearly demonstrates that simple interventions for mothers and children work. We now need the political will to deliver and turn goals into lives saved.”

What is the real cost?

The myth that neonatal care has to be high cost, was debunked a long time ago. What is desperately needed is the implementation of simple, low-cost interventions during delivery and in the vulnerable days and week post-partum, both in the facility and at home.

A few basic critical steps can increase a newborn’s chances of survival significantly – these include keeping the baby warm, initiating breastfeeding within the first hour after giving birth, giving special care to underweight newborns and immediately tending to complications such as difficulty breathing or infections.

These costs are relatively insignificant compared to the gift of life – a gift that is either denied or stolen from many families too soon.

Nandipa holds her son close as the sister carefully runs through a checklist to assess the newborn’s health. The next four weeks will be critical to the little boy’s survival. He braved and survived the most life-threatening act of birth, but the dangers of infection and pneumonia are still very real to this fragile life. Together with Silindokuhle, the world waits for a good thing to happen, the good thing of reducing neonatal and child mortality. The interventions already exist, but without implementation the dawn of every day marks yet another missed opportunity.